Risultati per: Infezione da Helicobacter pylori: review

Circulation, Volume 150, Issue Suppl_1, Page A4131381-A4131381, November 12, 2024. Background:Dietary interventions play a crucial role in weight management and reducing cardiovascular risk factors. Our study aims to compare the effectiveness of four dietary macronutrient interventions on weight loss and cardiovascular (CV) risk factor reduction through a systematic review and network meta-analysis.Methods:We conducted a comprehensive literature search on PubMed, Scopus, Embase, and Cochrane Library up till May 2024 to identify randomized controlled trials (RCTs) comparing four macronutrient dietary interventions including Mediterranean Diet (MD), Keto, Dietary Approaches to Stop Hypertension (DASH), and Intermittent Fasting (IF) with study period ≥ 6 months or 24 weeks. The primary outcomes of interest were weight loss, systolic blood pressure (SBP), Diastolic blood pressure (DBP), Body Mass Index (BMI), High density lipoprotein (HDL), Low density Lipoprotein (LDL), cholesterol levels and C-reactive protein (CRP) levels. Outcomes were reported as standard mean difference (SMD).Results:Our analysis identified 50 studies enrolling 5368 patients (MD=3554; DASH=838; Keto=206; IF=770). Regarding BP outcome, MD and DASH had significant reduction in SBP and DBP respectively (MD [SBP]: -0.76 mmHg vs DASH [DBP]: -1.92 mmHg) respectively. In contrast, IF showed a significant rise in SBP (0.87). MD participants also had significant weight loss (-1.06 kg) and a moderate decrease in BMI (-0.79) when compared with other diets. Furthermore, IF, keto, and MD showed moderate increase in HDL levels (0.61, 0.77 and 0.33) respectively. In contrast, DASH resulted in a moderate decline in HDL levels (-0.92). IF and MD resulted in modest decline in LDL levels (-0.45 and -0.42) respectively. In contrast, Keto demonstrated non-significant rise in LDL (0.35). DASH showed a significant decrease in triglycerides (-3.02). Lastly, MD demonstrated a significant reduction in CRP (-0.89).Conclusions:MD and DASH were superior to other dietary interventions in terms of weight loss and CV risk factors. Further research is required to tailor specific types of dietary interventions and assess their long-term efficacy on weight loss and CV risk reduction.

Circulation, Volume 150, Issue Suppl_1, Page A4146462-A4146462, November 12, 2024. Background:Recurrent ventricular tachycardia (VT) is common in patients with ischemic heart disease (IHD), even with anti-arrhythmic drugs on board. While ICDs can abort VT episodes, ICD shocks can be painful. Ablation therapy can reduce the number of ICD shocks and interventions, but the optimal ablation technique is still uncertain.Purpose:We aim to review the clinical efficacy and safety of catheter ablation vs anti-arrhythmic drugs in patients with IHD.Methods:We conducted comprehensive searches across PubMed, CENTRAL, WOS, Scopus, and EMBASE until Feb 2024. Pooled data were reported using risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, along with a 95% confidence interval (CI). This systematic review and meta-analysis was registered with PROSPERO ID: CRD42024551760.Results:We included seven RCTs with a total of 836 patients. Patients who underwent ablation had a lower risk of VT storm compared to those who received anti-arrhythmic drugs [RR: 0.65 with 95% CI (0.49, 0.87), P < 0.01), Compared to anti-arrhythmic drugs, the catheter ablation group also required less Appropriate ICD therapy [RR: 0.72 with 95% CI (0.57, 0.90), P < 0.01), and fewer ICD shocks [ RR: 0.64 with 95% CI (0.45, 0.93), P = 0.02). However, there was no significant difference in VT recurrence [RR: 0.91 with 95% CI (0.74, 1.14), P = 0.42), all-cause mortality [RR: 0.87 with 95% CI (0.65, 1.16), P = 0.34), or any adverse events [RR: 0.96 with 95% CI (0.50, 1.84), P = 0.91) between the two groups.Conclusion:Our meta-analysis showed that catheter ablation was associated with a reduction in VT storm, ICD therapy, and ICD shocks. However, when compared to anti-arrhythmic drugs, catheter ablation for VT in IHD patients did not appear to afford any significant survival advantage.

Circulation, Volume 150, Issue Suppl_1, Page A4145287-A4145287, November 12, 2024. BACKGOUND:Statins have shown benefits in the prognosis of patients with heart failure with reduced ejection fraction (HFrEF). However, the effects of statin in patients with heart failure with preserved ejection fraction (HFpEf) remains unclear. Therefore, we aim to perform an updated systematic review and propensity scores (PS) meta-analysis comparing statin with no statin therapy in this population.METHODS:We searched in PubMed, Embase, and Cochrane Library databases for studies examining the effect of statin use in patients with HFpEF. The primary outcome was (1) all-cause mortality, with secondary outcomes being (1) cardiovascular (CV) mortality and (3) heart failure (HF) hospitalization. We also performed a subgroup analysis for the primary outcome, comparing studies that used PS and studies that did not adjust the baseline covariates.RESULTS:We included in this meta-analysis a total of 17 studies. Our study encompassed 43,911 patients with HPpEF, of whom 19,142 (43.59%) received statin therapy. The mean age was 66.95 years, with a mean follow-up of 3.08 years. In the pooled analysis, statin was significantly associated with reduced all-cause mortality (HR 0.68; 95%CI 0.62-0.76; p

Circulation, Volume 150, Issue Suppl_1, Page A4137019-A4137019, November 12, 2024. Background:Despite the effectiveness of drug-eluting stents (DES) in preventing restenosis, many patients still experience DES restenosis. Neointimal hyperplasia and neoatherosclerosis can develop within these stents, leading to recurrent coronary syndromes.Hypothesis:Repeated stenting with DES is limited by additional metal layers, the need for prolonged dual antiplatelet therapy, and heightened risks of stent thrombosis. Locally acting drugs with sustained efficacy may prevent this progression. Paclitaxel delivery via contrast medium or drug-coated balloon catheters could exert antiproliferative effects, reducing neointimal proliferation.Aims:To synthesize existing evidence on the efficacy and safety of Paclitaxel-Coated Balloons versus Uncoated Balloons in coronary in-stent restenosis.Methods:Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched five electronic databases (PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science) to identify eligible studies reported up to March 23, 2024. Using R version 4.4.0, we reported outcomes as risk ratios (RRs) or mean differences (MD) and confidence intervals (CIs). This review has been registered and published in PROSPERO (CRD42024527412).Results:The meta-analysis included a total of six trials with 1,541 patients. PCB significantly reduced the incidence of myocardial infarction (RR 0.65, 95% CI [0.42, 1.00], p = 0.052), stent thrombosis (RR 0.26, 95% CI 0.08, to 0.83], p = 0.023), major adverse cardiac events (RR 0.32, 95% CI 0.25, to 0.42], P < 0.001), target lesion revascularization (RR 0.34, 95% CI [0.14, 0.84], p < 0.001). No significant differences were observed between PCB and UCB regarding cardiac-related mortality, target vessel revascularization, percutaneous coronary intervention, all-cause death, Q wave and non-Q wave myocardial infarction, coronary artery bypass grafting, and target vessel failure.Conclusion:PCB for ISR significantly reduced the incidence of myocardial infarction, MACE, and stent thrombosis compared to UCB.

Circulation, Volume 150, Issue Suppl_1, Page A4146837-A4146837, November 12, 2024. Background:Bruton Tyrosine Kinase inhibitors (BTKi) are targeted therapies that have demonstrated promising results in the treatment of hematological malignancies; however, they are associated with adverse cardiac events. Direct comparisons of the cardiotoxic profile between old-generation and new-generation BTKi are limited.Research Question:Are novel BTKi associated with a lower incidence of cardiac adverse events compared with ibrutinib?Aims:We aimed to perform a systematic review and meta-analysis of cardiac events from studies comparing new-generation BTKi versus ibrutinib in patients with hematological malignancies.Methods:We searched PubMed, Embase, and Cochrane Library for studies comparing any new-generation BTKi with ibrutinib in patients with hematological malignancies. Outcomes included 1) risk of cardiac events; 2) atrial fibrillation (AF); 3) rate of treatment discontinuations due to AF; and 4) hypertension. We pooled risk ratios (RR) with 95% confidence intervals (CI). Statistical analysis was performed using R software 4.3.1, under a random-effects model. Heterogeneity was assessed using I2statistics.Results:We included four randomized controlled trials with 1905 patients, of whom 957 (50%) received new-generation BTKi. Age ranged from 28 to 90 years, with 1337 (70%) male patients. Prior lines of systemic therapy ranged from none to 12. Overall cardiac events were significantly lower in patients who received novel BTKi compared with those who received ibrutinib (RR 0.75; 95% CI 0.63 to 0.90; p=0.002; I2=0%; Fig.1A). New-generation BTKis were associated with a statistically significant reduction in the risk of AF (RR 0.48; 95% 0.35 to 0.64; p

Circulation, Volume 150, Issue Suppl_1, Page A4147488-A4147488, November 12, 2024. Background:Previous studies have shown that influenza vaccination (IV) may reduce the incidence of cardiovascular events in patients with cardiovascular disease. In this meta-analysis, we aimed to clarify the effects of IV in patients with myocardial ischemia (MI) and heart failure (HF).Hypothesis:The influenza vaccine reduces the incidence of major adverse cardiovascular events among patients with MI and HF.Methods:A comprehensive search was performed in PubMed, Cochrane Library, and Embase databases from inception up to march 2024. We included randomized clinical trials (RCTs) that assessed the effects of IV in patients with HF and MI, and reported outcomes of major adverse cardiovascular events (MACE), cardiovascular death, and all-cause death. Analyses were conducted using R software. Heterogeneity was assessed using the I2 statistic. A random-effects model was applied to calculate pooled Relative Risk (RR). A stratified analysis was performed to investigate ST-segment elevation myocardial infarction (STEMI) and non-STEMI subgroups. Sensitivity analysis was performed to explore heterogeneity. Confidence Interval (CI) was set at 95%.Results:We identified six RCTs comprising a total population of 9229 participants. Of these, 4100 were patients with MI, and 5129 were HF patients. Overall, MACE (RR 0.65; 95%CI 0.47-0.89; p=0.007; I2=75%) (Figure 1A) and cardiovascular death (RR 0.60; 95%CI 0.37-0.96; p=0.035; I2=62%) (Figure 1B) were significantly lower in group receiving IV compared to placebo/no treatment. No statistically significant difference was observed for all-cause death. In sensitivity analysis, after excluding HF patients, IV significantly decreased the risk of MACE (RR 0.57; 95%CI 0.43-0.76; p

Circulation, Volume 150, Issue Suppl_1, Page A4135270-A4135270, November 12, 2024. Introduction:A growing body of evidence from randomized controlled trials (RCTs) has demonstrated the superiority of transcatheter aortic valve replacement (TAVR) over surgical aortic valve replacement (SAVR) irrespective of surgical risk in patients with severe aortic stenosis (SAS). Given the rise in TAVR procedures, analyzing trends in outcomes over time is critical to aid clinical decision-making. Hence, we pooled RCT data for a robust assessment of clinical and procedural outcomes in SAS patients undergoing TAVR and SAVR.Methods:PUBMED and SCOPUS were queried until April 2024. Trials were classified into high and low-risk groups based on surgical risk. The outcomes were analyzed at 30 days (short-term), 1 year (mid-term), and 5 years (long-term). Estimates were calculated as random effects risk ratios (RRs) with 95% confidence intervals (CI).Results:10 RCTs with a total of 10,252 patients were included. There was no significant association between TAVR and SAVR in reducing all-cause mortality at 30 days (RR: 0.84 [0.64, 1.10]; Figure 1a). While TAVR was associated with a significantly lower all-cause mortality at 1 year (RR: 0.82 [0.68-0.97]; Figure 1b), it was linked with a significantly higher all-cause mortality at 5 years (RR: 1.14 [1.07-1.21]; Figure 1c). Myocardial infarction and stroke were similar in both groups up to 5 years. TAVR was associated with a lower risk of acute kidney injury for up to 1 year and atrial fibrillation for up to 5 years but a higher risk of new permanent pacemaker implantation and aortic valve re-intervention for up to 5 years. In low-risk patients, TAVR showed no significant differences from SAVR for all-cause mortality at 30 days and 5 years, but it was significant at 1 year. In high-surgical-risk patients, all-cause mortality was comparable between TAVR AND SAVR at 30 days and 1 year, with a higher rate observed with TAVR at 5 years.Conclusion:Compared with SAVR, TAVR was superior in reducing all-cause mortality at 1 year in low-risk patients and inferior in reducing all-cause mortality at 5 years in high-risk patients. A thorough evaluation of anatomical, clinical, and procedural factors is crucial to tailor the optimal intervention for each patient.

Circulation, Volume 150, Issue Suppl_1, Page A4143604-A4143604, November 12, 2024. Background:Rivaroxaban is a novel oral anticoagulant suggested as an alternative to low molecular weight heparin (LMWH). However, its efficacy and safety compared to LMWH for treating venous thromboembolism (VTE) in cancer patients remain unclear.Hypothesis:This study aims to compare the efficacy and safety of rivaroxaban against LMWH for treating VTE in cancer patients.Methods:We conducted a literature search for relevant articles on PubMed, Google Scholar, and Embase. Outcomes were pooled using the DerSimonian and Laird random-effects model as risk ratios (RR) with 95% confidence intervals (CI). A p-value of

Circulation, Volume 150, Issue Suppl_1, Page A4117397-A4117397, November 12, 2024. Background:Diabetes Mellitus (DM) significantly impacts global health through cardiovascular and renal complications. SGLT2 inhibitors (SGLT2i) have emerged as beneficial for cardiovascular outcomes in Type 2 Diabetes Mellitus (T2DM). However, only few studies report outcomes related to renal function.Aim:This study aims to analyse the efficacy of SGLT2i on cardiorenal outcomes in adults with T2DM.Methods:A systematic review and meta-analysis, following PRISMA-2020 guidelines was conducted. We evaluated the efficacy of SGLT2i on cardiorenal outcomes in adults with T2DM. We included randomized controlled trials(RCT) and post hoc analyses that compared SGLT2i with placebo, focusing on cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke, heart failure hospitalizations, and renal outcomes such as the progression of albuminuria and the decline of eGFR. Dichotomous outcomes were calculated using relative risk (RR) with 95% confidence interval (CI).Results:We identified 2753 studies, registered in PubMed(=788), Embase(n=538), WoS(n=369), Scopus(n=908), and Cochrane(n=150). We included 11 studies 6 RCT and 7 Post Hoc Analysis, sample size of 50.653 patients. Meta-analysis showed that SGLT2i improve cardiovascular outcomes such as reduced cardiovascular mortality (RR 0.84 [95% CI 0.73–0.97] p=0.02), heart failure hospitalizations (RR 0.65 [95%CI 0.54–0.77]p

Circulation, Volume 150, Issue Suppl_1, Page A4146716-A4146716, November 12, 2024. Background:Femoral access is predominantly used for mechanical thrombectomy in stroke patients with large vessel occlusions. Following interventional cardiology guidelines, routine radial access has been proposed as an alternative, though its safety and efficacy remain controversial. We aimed to evaluate the efficacy and safety of radial versus femoral access for mechanical thrombectomy in patients with stroke.Hypothesis:In mechanical thrombectomy for stroke patients with large vessel occlusions, could the transradial access (TRA) result in comparable efficacy but fewer access site complications compared to transfemoral access (TFA)?Methods:A systematic search was performed in PubMed, Scopus, Cochrane, Embase, and Web of Science databases from inception to May 2024, to identify studies measuring the efficacy and safety of radial versus femoral access for mechanical thrombectomy in patients with stroke. The meta-analysis was performed using the Review Manager and Open Meta Analyst.Results:Ten studies (2,277 participants) were included in the review. There were no significant differences between radial and femoral access in terms of successful recanalization (0R: 1.01; 95% CI, 0.59,1.73; p=0.98), complete recanalization (OR: 1.08; 95% CI, 0.60,1.94; p=0.81), favorable functional outcomes (0R: 0.86; 95% CI, 0.53,1.41; p=0.56), first-pass reperfusion (OR: 0.89; 95% CI, 0.67,1.19; p=0.44), number of passes (MD: 0.10; 95% CI, -0.13,0.33; p=0.4), access-to-reperfusion time (MD: -3.92; 95% CI, -9.49,1.65; p=0.17), or symptomatic intracranial hemorrhage (OR: 0.95; 95% CI, 0.55,1.65; p=0.86). However, access site complications were significantly less frequent in the TRA group as compared with the TFA group (OR: 0.21; 95% CI, 0.08,0.60; p=0.004). Meta-regression showed no significant associations for publication year, mean age, gender, or baseline NIHSS scores with clinical outcomes.Conclusion:This meta-analysis indicates that TRA and TFA provide comparable outcomes in mechanical thrombectomy for acute ischemic stroke, with TRA resulting in fewer access site complications. Further large-scale randomized trials are recommended to confirm these findings and potentially support a shift towards TRA in neurovascular procedures.

Circulation, Volume 150, Issue Suppl_1, Page A4140895-A4140895, November 12, 2024. Background:Red cell distribution width (RDW) is a measurement of variability in erythrocyte size and volume, routinely reported as part of a complete blood count. Recently, it has gained popularity as a novel prognostic biomarker for cardiovascular disease outcomes. Our study investigates the predictive value of pre-procedural RDW for all-cause mortality (ACM) within one year for patients undergoing transcatheter aortic valve implantation (TAVI).Methods:We comprehensively reviewed databases like PubMed, Google Scholar, Embase, and Scopus until May 2024, looking for studies reporting an association between pre-procedural RDW and outcomes in TAVI. A binary random effects model was used to calculate the pooled adjusted odds ratio (aOR), and subgroup analysis was performed. I2 statistics were used to determine the heterogeneity of studies, further enhancing the robustness of our research.Results:Our systematic review and meta-analysis included five studies (three retrospective, two prospective) encompassing 2,565 patients with a mean age of 81.32 years. Our study showed a slight female predominance (52%). The mean follow-up period was one year. Comorbidities like coronary artery disease, diabetes melitus, atrial fibrillation, prior myocardial infarction were commonly reported among the study population. Higher pre-procedural RDW was associated with increased odds of ACM at the end of one year with an unadjusted pooled OR 1.86 (95% CI: 1.30-2.67, p

Circulation, Volume 150, Issue Suppl_1, Page A4145690-A4145690, November 12, 2024. Background:Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular benefits beyond glycemic control, including potential anti-arrhythmic effects. The impact of SGLT2 inhibitors on atrial fibrillation (AF) recurrence following catheter ablation in diabetic patients is an area of emerging interest. The purpose of this meta-analysis was to evaluate the impact of SGLT2 inhibitors on AF recurrence following catheter ablation in patients with diabetes.Methods:A comprehensive literature search was carried out using PubMed, Embase, and Google Scholar databases for the studies comparing SGLT2 inhibitors with other antidiabetic drugs in AF patients undergoing catheter ablation. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Statistical significance was set at p < 0.05. Egger's regression test and Begg-Mazumdar's rank test were used to assess publication bias. The primary endpoint was the reoccurrence of atrial fibrillation after catheter ablation during the follow-up period, which varied between studies and ranged from 12 to 33 months.Results:The analysis included six studies, involving a sample size of around 5,765 AF patients. Our study reported that the use of SGLT2 inhibitors in diabetic patients undergoing catheter ablation for AF was associated with lower odds of AF reoccurrence (OR: 0.46; 95% CI: 0.32 to 0.65; p 0.05).Conclusion:The use of SGLT2 inhibitors was associated with improved outcomes post-catheter ablation for AF diabetic patients. Further large-scale, randomized controlled trials are warranted to confirm these findings and elucidate the underlying mechanisms.

Circulation, Volume 150, Issue Suppl_1, Page A4125076-A4125076, November 12, 2024. Background:Combined catheter ablation (CA) with left atrial appendage closure (LAAC) may produce comprehensive treatment for atrial fibrillation (AF) whereby rhythm control is achieved and stroke risk is reduced without the need for chronic oral anticoagulation. However, the efficacy and safety of this strategy is still controversial.Aim:To investigate the efficacy and safety of a combined CA with LAAC approach to treat AF in patients moderate-to-high-risk for bleeding.Methods:This meta-analysis was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Medline, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Risk of bias was assessed using the Modified Newcastle-Ottawa scale and Cochrane risk of bias tool. Eligible studies reported outcomes in patients with AF who underwent combined CA and LAAC versus CA alone. Studies performing CA without pulmonary vein isolation were excluded.Results:Eight studies comprising 1878 patients were included (2 RCT, 6 observational). Pooled results showed no difference in arrhythmia recurrence (risk ratio [RR] 1.05; 95% confidence interval [CI] 0.84-1.30), stroke or systemic embolism (RR 0.71; 95% CI 0.26-1.94), total procedure time (mean difference 31.45 minutes; 95% CI -5.91-68.81), or major periprocedural complications (RR 1.28; 95% CI 0.28-5.89) when comparing combined CA and LAAC versus CA alone.Conclusion:Combined CA with LAAC for AF is associated with similar rates of arrhythmia free survival, stroke, major periprocedural complications, and procedure time when compared to CA alone. A combined strategy may be as safe and efficacious for patients moderate-to-high-risk for bleeding events to negate the need for chronic oral anticoagulation.

Circulation, Volume 150, Issue Suppl_1, Page A4146994-A4146994, November 12, 2024. Introduction:Guideline-directed medical therapy (GDMT) in patients with heart failure with reduced ejection fraction (HFrEF) remains underprescribed despite overwhelming evidence of clinical benefit. Electronic health record (EHR)-based clinical decision support (CDS) tools provide healthcare providers with evidence-based recommendations and reminders within the electronic health record system. EHR-based CDS tools offer an innovative and economical strategy to enhance GDMT prescription rates.Hypothesis:We hypothesized that EHR-based CDS is associated with increased GDMT initiation or dosage intensification in patients with HFrEF.Methods:We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published from inception to May 2024 on four databases: PubMed, Embase, CENTRAL, and MEDLINE. We included RCTs that assessed the impact of EHR-based CDS on GDMT initiation or dosage increase in patients with HFrEF. The primary outcome was a composite of GDMT initiation or dosage increase. Random effects meta-analysis was performed by Review Manager version 5.4 software. I2statistics was used to assess heterogeneity.Results:Out of 6716 retrieved studies, 5 RCTs involving 4881 patients met inclusion criteria. The inter-rater agreement was excellent (κ = 0.911). The primary outcome showed an overall effect size of 1.38 (95% CI: 1.00-1.91, P = 0.05; I2= 86%). Adjusted relative risk was not reported for most studies, and hence this data could not be provided. Visual inspection of the funnel plot was balanced.Conclusions:This meta-analysis indicates that EHR-based CDS tools show a potential to increase initiation of GDMT or increase GDMT dosage in HFrEF patients. Further investigation is required to validate these findings due to significant heterogeneity and limited included studies.

Circulation, Volume 150, Issue Suppl_1, Page A4145376-A4145376, November 12, 2024. Background:Carbon monoxide (CO) poisoning is a significant public health threat, with emerging attention on its cardiovascular consequences such as myocardial injury, heart failure, and arrhythmias. Notably, atrial fibrillation (AF) has been sporadically reported, suggesting a potential link between CO exposure and cardiac dysrhythmias.Case Report:A 72-year-old female with hypothyroidism and IBS presented to the emergency department with sudden gait imbalance, dizziness, and an occipital headache. Her ECG showed new-onset atrial fibrillation, with subsequent unremarkable echocardiography and brain imaging. Remarkably, her husband exhibited similar symptoms and both had recently been camping. Suspecting CO poisoning, carboxyhemoglobin was tested and found to be 2.9%, with no methemoglobinemia. The patient spontaneously converted to normal sinus rhythm during hospitalization and maintained it during hospitalization without hyperbaric oxygen therapy.Systematic Review of Case Reports: We identified seven cases of carbon monoxide-induced atrial fibrillation from 45 citations. Patients were mostly male (57.14%), aged 21 to 82, and presented with diverse symptoms, primarily headache (57.1%) and nausea (57.1%). Rapid ventricular response occurred in 85.7% of cases, none with a prior history of atrial fibrillation. Most (85.7%) returned to normal sinus rhythm upon discharge, and 71.4% maintained it on follow-up. Normobaric oxygen therapy was given in 57.1% of cases, and hyperbaric oxygen in 42.9%. Most patients (85.7%) had no known cardiovascular disease.Discussion:Despite being underexplored, evidence suggests a notable escalation in dysrhythmia risk, particularly in patients with pre-existing cardiovascular conditions, following acute CO poisoning. Potential mechanisms for CO-induced dysrhythmias include the strong binding of CO to hemoglobin, resulting in hypoxia-induced myocardial changes, and molecular alterations affecting cardiac voltage-gated channels.Conclusion:While the association between acute CO poisoning and dysrhythmias warrants further investigation, emerging evidence underscores the necessity of raising awareness among healthcare providers regarding the potential cardiovascular consequences of CO exposure.

Circulation, Volume 150, Issue Suppl_1, Page A4134877-A4134877, November 12, 2024. Background:Cardiovascular disease (CVD) remains a leading cause of death globally, yet disparities in CVD outcomes among sexual minorities compared to heterosexual adults are under-researched. Sexual minorities face unique stressors, discrimination, and barriers to healthcare, which may contribute to higher CVD risk. This meta-analysis synthesizes evidence on health disparities between sexual minorities and heterosexual adults.Methods:We searched MEDLINE, Cochrane, and Embase databases for studies published between 2002 to 2024 that compared cardiovascular health disparities between sexual minorities and their heterosexual counterparts. Outcomes were CVD, Diabetes, Hypertension, and Obesity. We pooled odds ratios (OR) for binary endpoints with 95% confidence intervals (CI) using a random-effects model. Statistical analyses were performed using R software version 4.3.2.Results:We included 9 Cross-sectional studies after minimizing population overlap, comprising 1,938,814 patients with a mean age of 47 years. There were no significant differences in the odds of CVD (OR 1.10; 95% CI 0.87 to 1.39; Figure 1 A), Diabetes (OR 0.88; 95% CI 0.74 to 1.04; Figure 1 B), hypertension (OR 1.07; 95% CI 0.97 to 1.19; Figure 2 A) and Obesity (OR 1.01; 95% CI 0.76 to 1.35; Figure 2 B) between groups. In subgroup analysis, there were higher odds of obesity in the sexual minority population when compared to their heterosexual counterparts (OR 1.29; 95 % CI 1.15 to 1.45) and higher hypertension odds in sexual minority men (OR 1.35; 95% CI 1.12 to 1.63).Conclusion:In this meta-analysis, we found no statistically significant difference in the prevalence of CVD, diabetes, and obesity between sexual minorities and heterosexuals, meaning that more studies are necessary to assess this difference. Subgroup analyses revealed sexual minority men had higher odds of hypertension and sexual minority women for obesity.